Most research on the effects of compensation has concentrated on examining outcomes rather than considering the compensation process itself. There has been little attention paid to the interactions between stakeholders and only recently has the client’s view been considered as worthy of investigation. This systematic review aimed to identify and synthesize findings from peer reviewed qualitative studies that investigated injured workers interactions with insurers in workers’ compensation systems.

Conclusion: Interactions between insurers and injured workers were interwoven in cyclical and pathogenic relationships, which influence the development of secondary injury in the form of psychosocial consequences instead of fostering recovery of injured workers. This review suggests that further research is required to investigate positive interactions and identify mechanisms to better support and prevent secondary psychosocial harm to injured workers.